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Neighbourhood effects on hospitalization in early childhood
Lan T H Vu1, Nazeem Muhajarine
1Department of Epidemiology, Hanoi School of Public Health, Hanoi, Vietnam.
Insights
Childrens neighbourhood environment impacts hospitalization risk, independent of family factors. Disadvantaged, poor physical condition, and overcrowded neighbourhoods increase childhood hospitalizations.
Area of Science:
- Public Health
- Environmental Health
- Child Health
Background:
- Childhood hospitalization rates are influenced by various factors.
- Understanding the role of neighbourhood characteristics is crucial for public health interventions.
- Socio-economic, environmental, and social factors in neighbourhoods may impact child health outcomes.
Purpose of the Study:
- To investigate the association between neighbourhood characteristics and childhood hospitalization rates.
- To determine if neighbourhood factors influence hospitalization risk independently of individual-level factors.
- To examine the impact of socio-economic disadvantage, physical infrastructure, social disconnection, and overcrowding on child hospitalizations from birth to age six.
Main Methods:
- A population-based cohort study of 8,504 children born in Saskatoon, Canada (1992-1994).
- Retrospective follow-up of children until age six, linking birth registry and health care utilization data.
- Longitudinal, multilevel design incorporating neighbourhood data from the 1991 Census and local sources.
Main Results:
- Individual factors associated with higher hospitalization rates included male sex, young maternal age, Aboriginal status, low family income, and adverse birth outcomes.
- Neighbourhood-level factors significantly linked to increased hospitalization rates were economic disadvantage, poor physical condition, and larger average household size.
- These neighbourhood effects persisted independently of individual-level risk factors.
Conclusions:
- Neighbourhood environment significantly impacts children's hospitalization risk, beyond family characteristics.
- Findings support a 'healthy community' approach promoting safe, health-promoting environments for families.
- Community development and public policy are vital for mitigating neighbourhood-level risks to child health.
Objective:
To determine whether characteristics of neighbourhoods in which children live, such as socio-economic disadvantage, physical infrastructure, programs and services, social disconnection, smoking prevalence, and overcrowding, are related to hospitalization rates from birth to age six, independent of individual-level factors.
Methods:
We studied a population of 8,504 children born in Saskatoon, Canada, over a three-year period (1992-1994). The birth cohort was retrospectively followed until children reached age six. Birth registry records were linked to health care utilization files to create continuous histories of health care utilization for each child. Information on the neighbourhood in which the child's family resided at his or her birth was extracted from Statistics Canada's 1991 Census and numerous local sources. A longitudinal and multilevel design was employed to examine the effect of neighbourhood characteristics and individual-level factors on childhood hospitalization rate.
Results:
Male children, children born to mothers under 20 years of age, Aboriginal children, children in low-income families, and those with adverse birth outcomes had significantly higher rates of hospitalization. In addition to these individual factors, children living in economically disadvantaged neighbourhoods, neighbourhoods in poor physical condition, and neighbourhoods with higher average household size had significantly higher rates of hospitalization.
Conclusions:
The kind of neighbourhood families live in has an impact on their children's risk of hospitalization, above and beyond the family's own characteristics. These findings provide additional support for a 'healthy community' approach that uses community development and healthy public policy to create safe, health-promoting neighbourhoods for all families.
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